Pediatric Urology & Pediatric Surgery

Pediatric Urology

Pediatric Urology is a surgical sub-specialty that caters to genitourinary disorders in children. New born babies until 15 years of age are diagnostically evaluated and surgically treated by Pediatric urologist for disorders of the Kidney, Ureter, Bladder, Testis and Reproductive System.

Some of the most common diseases that are treated by Pediatric Urologists but not limited to are:

  • Undescended Testis
  • Phimosis
  • Hydronephrosis
  • Hypospadias
  • Pediatric Kidney Stones
  • Urinary Infections
  • Vesicoureteric Reflux
  • Pelvi-Ureteric Junction Obstruction
  • Posterior Urethral Valves
  • Kidney Tumors
  • Hernia
  • Hydrocele
  • Testicular Torsion
  • Testicular Tumors
  • Exstrophy
  • Epispadias
  • Urethral Stricture
  • Duplex System
  • Ureterocele
  • Buried Penis
  • Disorders of Sex Development (Intersex)

Common symptoms associated with Pediatric Urologic Disorders:

  • Abnormal looking genitalia or penis:
    1. Hypospadias: It is a birth defect when the urethral opening is not present at the tip of the penis and is instead at the underside of the penis. This defect can be corrected with surgery.
    2. Epispadias: It is a birth defect in which the urethral opening is on the top side of penis. It can also be corrected with surgery,
    3. Intersex: It is a condition when the sex of the baby is questionable due to inconsistencies in the internal reproductive system and the external genitalia.
  • Pain in abdomen: Children who are older can describe and pinpoint the pain making it easier to diagnose. But in new-borns and infants pain in abdomen presents as irritation and excessive crying than usual. Various reasons can give rise to pain in abdomen:
    1. Stones
    2. Acute Pyelonephritis
    3. Pus or abscess in the kidney
    4. Pelvi-ureteric obstruction.
  • Fever
  • Any form of swelling in genital region.

Swelling in genital area is indicative of hernia ( abnormal protusion of the intestine into the scrotum), hydrocele ( abnormal fluid collection in scrotum), cyst or tumors.

  • Blood or pus in urine
  • Child crying during micturition.
  • Poor stream of urine, frequent urination, difficulty to pass urine or straining of urine or thin stream of urine and bed wetting are some of the associated symptoms of urological disorder.

Diagnostic Procedures in Pediatric Urology

  • Karyotyping: It is a test to that examines the genetic or the chromosomal makeup of a person. This helps in assessing various congenital anomalies.
  • Endoscopy of the Abdomen
  • Hormone Levels especially Testosterone and Cortisol
  • Ultrasound or Magnetic Resonance Imaging (MRI)
  • Urine and Serum Electrolytes
  • Radionuclide Cystogram

It is a special imaging test that aims at visualising the functioning of the urinary bladder and urinary tract.

  • Intravenous Pyelogram (IVP):

It is a non-invasive diagnostic procedure that involves injection a radiocontrast dye into the veins and then X-ray of the kidney, ureters and urinary bladder are taken.

  • X - Ray KUB (Kidneys, Ureter, Bladder)
  • Blood Urea Nitrogen (BUN)
  • Creatinine Clearance
  • Nuclear Scan of Kidneys
  • Voiding Cystourethrogram:

It is a technique employed to observe the bladder and the ureters when the child is micturating. In this procedure, a radiocontrast dye is injected into the catheter to fill the bladder and under the fluoroscopy; the anatomy and movement of the contrast is noted. The procedure ends with the child voiding urine which is also watched under the fluoroscopy since this is the time when the bladder has the highest pressure and helps in distinguishing various urological disorders from one and another.

Surgeries and Procedures in Pediatric Urology

  • Surgical Repair of Epispadias, Hypospadias: Urological surgery that is done to repair the defect of the urethral opening in the penis.
  • Bladder Exstrophy Repair:

Bladder Extrophy is a congenital anomaly in which the urinary bladder protrudes outside the abdominal wall through a defect in the abdomen. This is corrected through bladder extrophy surgery.

  • Herniotomy:

It is the surgical correction of hernia in children.

  • Hydrocele Repair Surgery:

This is a surgery that is carried out in children suffering from hydrocele wherein the abnormal fluid is collected in the scrotum.

  • Pyeloplasty:

It is a reconstruction surgery which is done in cases of uretero-pelvic junction obstruction cases to drain or decompress the kidney

  • Laparoscopic Pyeloplasty
  • Uretero-Uretrostomy
  • Deroofing of Ureterocele
  • Orchiopexy:

It is a surgery that is done for moving the undescended testis back into the scrotum and fix it permanently.

  • Laparoscopic Orchiopexy:

The process of bringing the undescended testis back into the scrotum through ha keyhole incision (laproscopic method) is called as laproscopic orchiopexy

  • Nephrectomy:

A surgical procedure to remove a part of kidney or the complete kidney in cases of tumors or congenital malformations of kidney.

  • Laparoscopic Nephrectomy
  • Hemi-Nephrectomy
  • PCNL (Percutaneous Nephrolithotomy):

It is a procedure that is carried out to remove large stones in the kidney. The procedure involves making a small cut in the back with the help of a fine needle under the radiological guidance and the stone is broken down into smaller pieces. This procedure is safe for kids and the cut on the back doesn’t exceed more than 5mm.

  • PCN (PerCutaneous Nephrostomy)
  • URS (Ureterorenoscopy):

It is a procedure that involves the use of an endoscope which is primarily used to remove stones that are stuck in the pelvi-ureteric region.

  • Cystoscopy:

A procedure that involves using an endoscope to visualise the urinary bladder by inserting through the natural urethral opening. Various sizes are available and are safe to use in children as well as newborns.

  • Re-Implantation of Ureters
  • Bladder Augmentation
  • Mitofanoff Procedure
  • ACE Procedure (Antegrade Colonic Enema)
  • Vaginoplasty; Clitoroplasty
  • Intersex Reconstruction
  • Gender Assignment Surgeries
  • Robotic Surgery:

An advanced form of minimal invasive surgery that involves using robotic aids in complicated surgery through minute cuts. It allows to carry out complex surgeries with more precision and flexibility.


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